Master plan Smart Hospital: well-connected is half cared for

Artificial intelligence makes the diagnosis, robots perform the surgery and physicians manage all processes via touchscreen – is that what hospitals of the future will look like? And how far away are we actually from this future? Many hospital facilities are already on their way to becoming Smart Hospitals with the latest technology and where everything and everyone is linked and connected.

A digitally organized hospital that intelligently connects all departments and entities is a concept that has been around for some time, but what does it entail? What is already part of today’s clinical routine and where is there a need to catch up?

Many institutions are already committed to a so-called "Master plan Smart Hospital". The goal is to improve patient care through digital processes and new technologies, while relieving staff of non-specialist activities at the same time. In the area of digitization, the plan is to achieve this via communication platforms, a cross-sector telemedicine network and apps that facilitate patient care or follow-up care. On top of that, hospitals progressively want to utilize new technologies such as artificial intelligence, robotics, and 3D printing.

Many smart solutions have already been realized or are at least well on their way to being implemented. Computer-assisted surgical systems like Brainlab's surgical navigation platform have been an integral part of surgical practice for several years. What's more, a number of projects study the use of augmented reality in the operating room and things look promising. In cardiology, 3D mapping to facilitate customized cardiac mapping of a patient’s heart is gaining in popularity. This technology lets physicians gain new insights into the heart of the individual patient. Artificial intelligence and machine learning used for radiographic assessments show great potential. The accuracy in the diagnosis of cancer or neurological diseases is amazing.

Some Smart Hospital aspects have already become clinical routine, especially in operating rooms. The Spital Thun (Thun Hospital) in Switzerland is a great example of this. Its Chief of Surgery is able to check on the monitor in the entrance area whether operating rooms are occupied and whether all surgeries go according to plan. In the OR, a computer provides access to all the surgical steps and the patient's electronic health record. The digital assistant indicates the proper order of the needed instruments and even performs certain surgical procedures if they have been selected via the touchscreen.

While the medical staff at the Spital Thun receives digital surgical assistance, the University Hospital of Essen features a robot that actually performs surgery. The "da Vinci" surgical system has four robotic arms. Three of them are equipped with disposable microsurgical instruments that facilitate minimally invasive surgery with incisions measuring less than one centimeter. The fourth arm features a three-dimensional camera system. Da Vinci is operated by trained and skilled physicians via a separate console. Physicians are able to obtain 3D images of the surgical field inside the patient’s body. More than 4,000 da Vinci surgical systems are currently in use worldwide.

When it comes to new technologies and innovations, some hospitals have already been able to successfully tick some of the boxes of their "Master plan Smart Hospital ". Meanwhile, the digitization aspect in terms of hospital connectivity as envisioned by the UNITY Company, seems to lag behind.

UNITY offers consulting services and guides healthcare facilities on their way to becoming a Smart Hospital. The company presents a case scenario that might take place in a connected hospital: There has been an accident. The emergency medicine physician collects the injured person's data and digitally transmits it to the hospital, which is subsequently able to prepare for treatment – long before the patient arrives at the facility. This ensures that the patient not only receives a speedy but also personalized treatment upon his/her arrival at the hospital. The medical specialist, who is unable to be right on-site is also connected using telemedicine solutions. The real-time location system and status assessment of medical devices ensure that physician and patient are promptly furnished with the necessary equipment. If needed, customized implants and other products can be produced thanks to the in-house 3D printer. The physician also digitally records the medication administration to ensure that medicine can be dispensed and picked up as quickly as possible via electronic prescription (e-Prescribing). All patient data is stored digitally in a cloud and can be immediately accessed at the next doctor's visit or hospital stay.

The first step and the foundation of a Smart Hospital - and this doesn’t just apply to this concept – is the electronic patient record. If all patient data is available in a digital format, it can be accessed by all departments and hospital stakeholders in no time at all. In an emergency, the physician is able to check for any pre-existing conditions or allergies the patient might have. Needless to say, this speeds up all subsequent treatment steps.

The electronic health record is planned as a database though it has not been implemented yet because there is still no legal framework. After all, data privacy concerns are inevitable wherever data is stored. Even though the corresponding regulations and restrictions are meant to ensure patient safety and personal data security, they slow down the pace of digital transformation and the overall development of the Smart Hospital at the same time. What’s more, there is often a lack of infrastructure to support connectivity.

All Smart Hospital concepts explicitly center on the patient and his/her well-being. Time and again, the fact that everything happens in the best interest of the patient is being emphasized. Yet this begs the question of whether constant data generation causes the patient to simply be perceived as precisely that: an accumulation of data. After all, how can a hospital where machines play such a major role in organization, as well as diagnostics and treatment, still be on the patient's side?

Despite the digital and technical processes, it is impossible to imagine a hospital without the human factor. Machines don’t have common sense and blindly do what human beings tell them to do. For example, if a machine learning program is fed with the wrong information, it subsequently learns wrong patterns. Only when human beings feed it with 100 percent accurate findings can artificial intelligence learn to make the correct diagnosis. And even a surgical robot does not operate fully on its own and is controlled by surgeons.

That's why we must keep one thing in mind for the future: Digitization is great, but human control is better. All entities at a Smart Hospital - people and machines – must, therefore, act intelligently.